How would you save the NHS?

what I'm saying that if I have had an illness whereby the treatment requires a doctor's prescriptions (i.e. let's say steroids for iritis or antibiotics for tonsillitis) my time that I have to wait to see a doctor ought to be in proportion to the certainty that I have the same illness again. if I've had it twice, I ought to see a doctor twice as quickly for it. if I have it three times, then maybe three times quicker, etc. I shouldn't be made to wait almost an hour just to reaffirm my own knowledge on what the obvious condition is. if I'm not allowed or trusted to get the prescription myself (which I think I ought to be if I have a history of a certain condition that I can prove), then at the very least I ought to have better access, because making me wait for almost an hour for no good reason for a very quick appointment is ****ing stupid.

How would you save the NHS?

I work in the NHS. This is how I would fix it:

0) Firstly, if anyone in charge had been acting for anything other than self-interest in the last 50 years we would not be in this situation. We knew a population bubble of elderly was coming literally since the 50s. We should have been saving for this event as a nation for 30 years, we should have increased the number of med school places and hospital beds starting 10 years ago, we should have increased nursing school places 5 years ago. We'd then have enough money, beds, doctors and nurses to live out the crisis over the next 10-15 years or so.
Instead, we've got the biggest national debt since WWII, 12% vacancy rate for doctors (with loads about to retire/return to Europe), 8% vacancy rate for nurses (with loads about to retire/return to Europe), and a bed crisis that means we rarely have free beds in the summer in year 1-2 of this 15+ year problem. We have been totally betrayed by the previous generation and so are totally screwed now no matter what we do. BUT there are some things we can do to ease it...

0a) Don't declare war on your staff immediately before the big crisis. Its really bad for staff retention and morale. Hunt didn't just introduce a new contract. He deliberately, repeatedly and publicly belittled and insulted his workforce (doctors and other). No wonder so many are looking abroad and 50% of 2nd year doctors didn't apply to continue (most will come back after a break, but that's a lot of doctor-years to lose).

1) Reduce the bureaucratic workload for front line staff. The current trend, which is ingrained into how doctors/nurses are hired and promoted, is that when there is a problem you introduce a new form to fill. There is no consideration that time spent form filling leads to problems in itself. Change the training and clinical governance structure to recognise that time is a commodity, and time having clinical staff filling out forms is a waste, not a good thing.

2) Don't leave the EU/soft brexit due to impact on recruitment. I know - boo not more brexit talk - but the NHS is one of the bodies set to lose out the most from Brexit. About 10% of doctors are from the EU. About a third of newly recruited nurses last year were from the EU. EU nurses are broadly better trained than UK ones (their training is longer and they practice more independently) and their English tends to be better than non-EU nurses.
It will also significantly impact on medical research, where funding, personnel and collaboration have become very intertwined with our EU neighbours.

3) No more PFI. Another way in which we've been sold out is PFI. My local hospital spends 22% of its budget on PFI buildings. Its now being asked to cut 20% of its budget... but PFI can't be cut. So that's actually 25% of its non-PFI budget.
25% cost-cutting whilst maintaining the same service. No business can do that.

4) Stop the national mandate to charge immigrants for emergency care. The government mandates hospitals create specific teams to chase payment from non-EU nationals for emergency treatment they received. These goon squads cost the NHS about twice what they make (unpublished data). Let the hospitals decide locally how to deal with such bills - it is them who get the money, its not like they lack incentive.

5) Increase funding to be in line with similar EU countries. We spend substantially less than e.g. France, Germany, Netherlands. I know its hard times what with needing to pay for Trident and brexit etc but simple fact is: you can't expect the NHS to deliver a comparable service to those who spend so much more.
OR
5a) Be honest to the public. Tell the public which services are going to be cut because the NHS can't afford it. Carrying on as we are is just illogical and bad for everyone. Surgeons sit around doing nothing because there are no beds to send patients to. Paramedics hang around outside as they can't drop off their patients. All the while cancer ops get cancelled and true life threatening emergencies have to wait hours for an ambulance. Someone needs to strap on their man pants and tell the public which expensive cancer drugs are going to be pulled and which operations aren't going to be offered so that we can free up money for more beds and staff. So that we can go back to having a functioning service.

6) Put most of the above funding and newly retained/acquired EU workforce into social services and care homes. An NHS bed costs about £200 per day even without any treatment being provided. A care home bed costs a lot less. Stop being inefficient and sort it out.
Additionally, care homes need to be banned from refusing to accept new patients on Fridays and weekends (as is common currently). For all Hunt's rhetoric on 7 day NHS, this is something he hasn't even attempted to tackle.

7) Reduce spend on locums, but not by just banning hospitals from paying for the staff they need as is the current approach. Reduce locum spending by making jobs attractive so you have enough staff in the first place. Insulting staff = bad for locum spending. Treating staff well = good. Revolutionary.

8) Reduce legal threat to hospital staff. I appreciate that the courts play a vital role in regulating the medical profession, but if we're to be able to deal with the current crisis we need to be able to look after patients, not filling out forms for a hypothetical legal case just in case someone sues, as is the case currently. I'm not saying it has to be total or permanent, but dealing with a crisis means making sacrifices. Closely linked to point 5a).

9) Rationalise private sector involvement. I believe there is a role for the private sector, but not in the way the government is doing things. Long contracts that give private companies effective monopolies (e.g. catering contracts in hospitals), and contracts where the company is minimally accountable for its standards (e.g. contracts to perform clinical scans or lab tests without then implementing substantial government-run quality control measures) just waste NHS resources. Hitchingbrooke was a complete scandal yet the government doesn't seem the slightest bit deterred (?).

10) Stop faffing around and get an IT system that works. Europe manages it - doctors/students there find it funny that we still have paper systems. Just pay them money and take their system. Denmark's is good, go with that. How hard can it be?
IT has so much potential to solve so many inefficiencies in day to day ward work, yet no one seems to take any action.

11) Proper education, but more about palliative care and options surrounding end of life rather than when/when not to attend A&E. Teaching people when to go to A&E is no small task, and there's loads of info out there - not least 111 (a terrible example of privatisation btw, but its still better than nothing). I think a large advertising campaign saying don't come to A&E because e.g. your finger nail came off will be expensive and have limited impact. They are also fairly easy cases to deal with.
HOWEVER - end of life is the opposite of that. Its something we don't often talk about, but surveys show there is a huge discrepancy between where people want to die (generally at home) vs where they do die (generally in hospital). Now its nowhere near as simple as just telling people to stay at home then - its a distressing time for relatives and they need support. But so often you see people coming in and going through the full works and getting admitted because obviously they're really sick... but actually they didn't want to be there. Their family brought them in because they were worried. I think clear education, for the patient and the family, on what the options are, on what might happen and how we can deal with that (in or out of hospital) would have a much bigger impact on hospital beds AND improve dignity regarding end of live.

But no matter what we do - and i suspect it will be none of the above - we are going to be for a hard hard time over the next few years. Pray that you/your loved ones don't get sick

TL.DR points in bold.

Teach people to be a little sharper with their general health. Quite a number of hospital visits are for completely avoidable problems that they could sort out themselves if they were just a little more aware.

-Also have an equivalent of A&E for less serious incidents so A&E doesn't have ridiculously long waiting times, they do at some hospitals but this should be standard.

Regarding private involvement, it's easy to argue contracts have to be long, the problem with short contracts is that if the enterprise is failing (which it probably is) it's just saying "private sector, come sort out our mess at great expense and then give it back to us after." For investment the investor needs to profit from it, something which tends not to happen on short contracts

Whats the evidence behind this?

What hospital visits should patients be self-treating?

I think this question highlights one of the reasons why the NHS is suffering.

I, personally, could do absolutely nothing to save the NHS. Nor could any other individual.

It is the responsibility of everyone to make sure that less pressure is placed on NHS services, be it through understanding when/when not to go to A&E or visit your GP, or living a healthier life so you don't develop a disease which is expensive to treat (such as diabetes).

If we give ourselves this idea that the only thing which could 'save' the NHS is some man or woman who can wave a magic wand and make it better is never going to help improve the situation of health in this country, which is pretty poor.

That wont get rid of people who actually need to use the NHS. I don't know why this needs pointing out. The NHS is not full of hypochondriacs.

How would you save the NHS?

I'd put it out of its misery. It's not sustainable. It's a sinkhole on the budget.

Singapore does healthcare far better than we do and we should learn from our friends abroad before we bankrupt ourselves.

Things like colds and coughs that I've seen people go to GP's for. Unless it's persistent, sure.

The GPs won't refer them to hospital if its not serious.

The crisis in the NHS is in hospitals, not because people are going to GPs for coughs and colds.

How would you save the NHS?

How would you save the NHS?

How would you save the NHS?

By putting 50% extra money in and joining social care into their remit


Posted from TSR Mobile

Only 50%?! Are you a dirty poor hate pro privatisation Tory?!?!?!?m?m?!!?!11?!!!

Posted from TSR Mobile

How would you save the NHS?